Urogynecology Treatment

Urogynecology is a fairly new subspecialty and a fast-growing one, with increasing rates of pelvic floor disorders fueling a high demand for its services. A urogynecologist is an OB-GYN with advanced training and expertise in the treatment of pelvic floor dysfunction in women. These doctors are specially trained to remove faulty transvaginal mesh implants.

Women affected by pelvic floor disorders such as stress urinary incontinence and pelvic organ prolapse are often referred to these specialists, as are women who are in need of specialized care for complications stemming from vaginal mesh procedures.

Pelvic Floor Disorders:

Pelvic floor disorders occur when the pelvic floor is weakened or stretched due to damage caused by childbirth, obesity, surgery, disease or activities such as high-impact sports or repetitive heavy lifting. Some of the most common problems women face due to pelvic floor disorders are:

  • urinary or fecal incontinence
  • pelvic or vaginal pain
  • difficulty emptying the bladder or bowels
  • pelvic organ prolapse (dropping of pelvic organs from their normal position)

Urinary Incontinence is the most common disorder. There are a wide variety of reasons why women become incontinent. It could be the result of pelvic muscle damage from pregnancy, infections, spinal injury, drug side effects, or the result of other conditions such as obesity or diabetes. Frequently there is a common family inherited predisposition to pelvic support weakness, leading to bulging pelvic discomfort and urinary incontinence.

Treatment:

Depending upon the severity of symptoms and the health of the patient, conservative, non-surgical therapies are often the first approach used in the treatment of pelvic floor disorders. These include medications, pelvic muscle exercise, lifestyle and dietary modifications, use of a vaginal support device called a pessary, biofeedback and electric stimulation of pelvic floor muscles. If these methods fail to provide adequate symptom improvement, surgery may be used to repair pelvic floor defects.

Transvaginal Mesh Removal:

Surgical procedures that use transvaginal mesh implants to repair pelvic floor disorders have been widely used by urogynecologists and others over the past decade. However, these synthetic mesh implants have proven problematic for a significant number of patients.

Mesh is intended to be a permanent surgical implant and can be very difficult to remove, since the body’s tissues grow into and around the implant. The skill and expertise brought to the table by a urogynecologist can increase the chances of successful revision surgery and decrease the risk of multiple procedures being necessary to repair the damage done by the mesh.